Background: Obesity has become a major global public health concern and is one of the strongest predictors of metabolic syndrome, cardiovascular disease, and type 2 diabetes mellitus. Metabolic syndrome comprises a cluster of metabolic abnormalities that significantly increase morbidity and mortality among adults.Objective: To determine the prevalence of obesity and metabolic syndrome among adults attending a tertiary care hospital and evaluate the association between obesity and metabolic risk factors.Methods: A retrospective observational study was conducted among 300 adults aged 18 years and above. Demographic characteristics, anthropometric measurements, blood pressure, fasting blood glucose, and lipid profiles were analyzed. Obesity was classified according to Body Mass Index (BMI), while metabolic syndrome was diagnosed using the International Diabetes Federation (IDF) criteria.Results: Among 300 participants, obesity was observed in 36.7%, overweight in 30.3%, and normal BMI in 33.0%. Metabolic syndrome was diagnosed in 34.3% of participants. Hypertension was present in 41.0%, dyslipidemia in 47.3%, impaired fasting glucose or diabetes in 38.0%, and central obesity in 52.7%. Metabolic syndrome was significantly more common among obese individuals (61.8%) compared with normal-weight adults (11.1%).Conclusion: Obesity and metabolic syndrome are highly prevalent among adults and are strongly associated with hypertension, dyslipidemia, and impaired glucose metabolism. Early identification and lifestyle modification are essential to reduce long-term cardiovascular and metabolic complications.